Individual
EVAN JAMES LUXENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
99 MONTECILLO RD, SAN RAFAEL, CA 94903-3308
(415) 444-2905
Mailing address
99 MONTECILLO RD., MEDICAL OFFICE BUILDING TWO 1ST FLOOR, SAN RAFAEL, CA 94903-3308
(415) 444-2905
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
187130
CA
2084N0400X
Neurology Physician
MD61278845
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457857609
—
WA
Enumeration date
04/04/2018
Last updated
07/27/2023
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